{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,6,14]],"date-time":"2026-06-14T09:16:42Z","timestamp":1781428602389,"version":"3.54.1"},"posted":{"date-parts":[[2025,12,23]]},"group-title":"Infectious Diseases (except HIV\/AIDS)","reference-count":56,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T00:00:00Z","timestamp":1766448000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2025,12,23]]},"abstract":"<jats:title>\n                  A\n                  <jats:sc>bstract<\/jats:sc>\n                <\/jats:title>\n                <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>\n                    <jats:italic>Plasmodium falciparum kelch13<\/jats:italic>\n                    (\n                    <jats:italic>k13<\/jats:italic>\n                    ) mutations in Africa signal emerging artemisinin partial resistance (ART-R), endangering malaria control by undermining artemisinin-based combination therapies (ACTs). Sparse surveillance obscures whether rising\n                    <jats:italic>k13<\/jats:italic>\n                    ART-R prevalence reflects local emergence or geographic expansion. We aimed to model and infer high-resolution spatial-temporal prevalence of\n                    <jats:italic>k13<\/jats:italic>\n                    ART-R and ACT partner-drug markers to inform public health policy.\n                  <\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>\n                    We conducted a systematic literature review (PROSPERO-ID CRD42024593923) spanning the years 2014\u20132025, complementing existing data from WWARN, MalariaGEN Pf7, and the WHO Malaria Threats Map. This integrated dataset, comprising 3,806 distinct molecular epidemiology surveys and 182,071 genotyped samples, was harmonized using a standardized data schema. We applied a spatial-temporal Gaussian process model to estimate the continuous prevalence of WHO\n                    <jats:italic>k13<\/jats:italic>\n                    ART-R mutations,\n                    <jats:italic>mdr1<\/jats:italic>\n                    86Y, and\n                    <jats:italic>crt<\/jats:italic>\n                    76T.\n                  <\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Findings<\/jats:title>\n                  <jats:p>\n                    ART-R increases were driven by distinct emergences of\n                    <jats:italic>k13<\/jats:italic>\n                    561H in Rwanda,\n                    <jats:italic>k13<\/jats:italic>\n                    675V in Uganda, and\n                    <jats:italic>k13<\/jats:italic>\n                    622I in Ethiopia and Eritrea. From 2012 to 2024, predicted\n                    <jats:italic>k13<\/jats:italic>\n                    prevalence rose steadily in Northern Province, Uganda (1.81% per year) and Northern Province, Rwanda (3.49% per year), reaching 26.36% in Uganda and 39.44% in Rwanda by 2024. Modelling indicated a rapid transition from localized\n                    <jats:italic>k13<\/jats:italic>\n                    ART-R mutation emergence to entrenched regional hotspots centred on Uganda\u2013Rwanda and the Ethiopia\u2013Eritrea border. Partner drug amodiaquine marker\n                    <jats:italic>mdr1<\/jats:italic>\n                    86Y is fading, but\n                    <jats:italic>crt<\/jats:italic>\n                    76T remains prevalent in the Horn of Africa.\n                  <\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Interpretation<\/jats:title>\n                  <jats:p>\n                    The rapid and multicentric expansion of\n                    <jats:italic>k13<\/jats:italic>\n                    ART-R mutations in East Africa threatens ACT efficacy, especially where ART-R\n                    <jats:italic>k13<\/jats:italic>\n                    and partner drug markers co-occur, mirroring early patterns observed before ACT failure in Southeast Asia. This study provides an updated\n                    <jats:italic>k13<\/jats:italic>\n                    ART-R mutation database and high-resolution resistance maps with uncertainty quantification, demonstrating a crucial need to prioritize targeted molecular surveillance across greater East Africa to safeguard ACT efficacy.\n                  <\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Funding<\/jats:title>\n                  <jats:p>US National Institutes of Health.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:label>1<\/jats:label>\n                  <jats:title>Research in Context<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Evidence before this study<\/jats:title>\n                    <jats:p>\n                      We searched OVID MEDLINE and PubMed databases: Pubmed was searched from database inception to July 9th 2025, using the following search terms: (((((((plasmodium falciparum) OR (falciparum))) AND (Africa)) AND (((resistance) OR (kelch13) OR (pfkelch13) OR (k13) OR (crt) OR (pfcrt) OR (mdr1) OR (pfmdr1)))) AND (((Sequencing) OR (markers) OR (genotyping))). This search identified 922 publications, of which 116 meet our inclusion criteria. We extracted the prevalence of all WHO-validated and candidate\n                      <jats:italic>k13<\/jats:italic>\n                      mutations (441L, 446I, 449A, 458Y, 469F, 469Y, 476I, 481V, 493H, 515K, 527H, 537I, 537D, 538V, 539T, 543T, 553L, 561H, 568G, 574L, 580Y, 622I, 675V),\n                      <jats:italic>mdr1<\/jats:italic>\n                      86Y, and\n                      <jats:italic>crt<\/jats:italic>\n                      76T for these studies. In Africa, ART-R resistance mutations have been increasingly detected beginning in 2013-2015, particularly in East Africa (Rwanda, Uganda) and the Horn of Africa (Ethiopia, Eritrea). Therapeutic efficacy studies (TES) generally show high ACT efficacy across the continent; nevertheless, the presence of\n                      <jats:italic>k13<\/jats:italic>\n                      resistance mutations is viewed as a high-priority public health threat. Prior efforts to map these molecular markers have been hampered by sparse and heterogeneous sampling, resulting in prevalence maps that rely on simple aggregation with wide, uninformative uncertainty intervals, limiting utility for national programs seeking to identify true increases in resistance. Furthermore, sub-continental estimates have often been static or limited in their ability to model the spatial and temporal dynamics of distinct mutation lineages.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Added value of this study<\/jats:title>\n                    <jats:p>\n                      This study provides the largest and most current harmonized dataset of\n                      <jats:italic>k13<\/jats:italic>\n                      ART-R and partner drug mutations in Africa with 182,071 samples and 3,806 surveys, integrating systematic literature review findings with major public databases (WWARN, MalariaGEN Pf7, and the WHO Malaria Threats Map). We used a spatial-temporal Gaussian process model to overcome the limitations of sparse sampling. This modelling approach enables the generation of continuous prevalence maps across space and time, simultaneously predicting prevalence in unsampled areas while rigorously quantifying the statistical uncertainty of those predictions. We provide the first contemporary, high-resolution maps that illustrate the concurrent selection dynamics of key partner drug markers (\n                      <jats:italic>mdr1<\/jats:italic>\n                      86Y and\n                      <jats:italic>crt<\/jats:italic>\n                      76T) alongside the expanding focus of ART-R.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Implications of all the available evidence<\/jats:title>\n                    <jats:p>\n                      The dramatic rise in\n                      <jats:italic>k13<\/jats:italic>\n                      ART-R mutations, coupled with the steady geographic expansion identified by our model, confirms that ART-R is now firmly established in East Africa. The colocalization of high prevalence\n                      <jats:italic>k13<\/jats:italic>\n                      ART-R mutations in Uganda and Rwanda with near-fixation of markers related to partner drug tolerance creates a molecular resistance profile highly reminiscent of the conditions preceding widespread treatment failure in Southeast Asia. This suggests the need to more broadly shift away from reliance on artemether-lumefantrine and necessitates greater molecular surveillance in sub-Saharan Africa, prioritizing the identified high-prevalence regions (Uganda, Rwanda, Ethiopia, Eritrea) and neighboring countries. Our integrated approach provides the foundational, evidence-based tools needed by national malaria control programs (NMCPs) and the WHO to refine drug policy decisions before ART-R develops into clinical treatment failure.\n                    <\/jats:p>\n                  <\/jats:sec>\n                <\/jats:sec>","DOI":"10.64898\/2025.12.22.25342873","type":"posted-content","created":{"date-parts":[[2025,12,24]],"date-time":"2025-12-24T00:05:18Z","timestamp":1766534718000},"source":"Crossref","is-referenced-by-count":2,"title":["Mapping the prevalence of molecular markers of\n                  <i>Plasmodium falciparum<\/i>\n                  artemisinin partial resistance in Africa: a spatial-temporal modelling study"],"prefix":"10.64898","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0131-7670","authenticated-orcid":false,"given":"Neeva","family":"Wernsman Young","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7833-5164","authenticated-orcid":false,"given":"C\u00e9cile P. G.","family":"Meier-Scherling","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gina","family":"Cuomo-Dannenburg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7924-7844","authenticated-orcid":false,"given":"George A.","family":"Tollefson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7330-7340","authenticated-orcid":false,"given":"Sean V.","family":"Connelly","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3592-1382","authenticated-orcid":false,"given":"Jacob","family":"Marglous","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7969-1910","authenticated-orcid":false,"given":"Isabela","family":"Gerdes Gyuricza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly","family":"Carey-Ewend","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-6522-4069","authenticated-orcid":false,"given":"Ronald","family":"Kyong-Shin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8308-5294","authenticated-orcid":false,"given":"Zachary R.","family":"Popkin-Hall","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayalew Jejaw","family":"Zeleke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2040-3416","authenticated-orcid":false,"given":"Deus S.","family":"Ishengoma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abebe A.","family":"Fola","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfred","family":"Simkin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karamoko","family":"Niar\u00e9","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan B.","family":"Parr","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa","family":"Conrad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucy C.","family":"Okell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0495-179X","authenticated-orcid":false,"given":"Shazia","family":"Ruybal-Pes\u00e1ntez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2374-0741","authenticated-orcid":false,"given":"Oliver J.","family":"Watson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0591-0850","authenticated-orcid":false,"given":"Jonathan J.","family":"Juliano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6899-8204","authenticated-orcid":false,"given":"Jeffrey A.","family":"Bailey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3902-8567","authenticated-orcid":false,"given":"Robert","family":"Verity","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"54368","reference":[{"key":"2025122622550972000_2025.12.22.25342873v1.1","unstructured":"World Health Organization. World malaria report 2025. World Health Organization, December 2025."},{"key":"2025122622550972000_2025.12.22.25342873v1.2","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-020-1005-2"},{"key":"2025122622550972000_2025.12.22.25342873v1.3","doi-asserted-by":"publisher","DOI":"10.3201\/eid2804.212269"},{"issue":"4","key":"2025122622550972000_2025.12.22.25342873v1.4","doi-asserted-by":"crossref","first-page":"ofad149","DOI":"10.1093\/ofid\/ofad149","article-title":"Examining the Early Distribution of the Artemisinin-Resistant Plasmodium falciparum kelch13 R561H Mutation in Areas of Higher Transmission in Rwanda","volume":"10","year":"2023","journal-title":"Open Forum Infectious Diseases"},{"issue":"1","key":"2025122622550972000_2025.12.22.25342873v1.5","doi-asserted-by":"crossref","first-page":"6353","DOI":"10.1038\/s41467-022-33873-x","article-title":"Decreased susceptibility of Plasmodium falciparum to both dihydroartemisinin and lumefantrine in northern Uganda","volume":"13","year":"2022","journal-title":"Nature Communications"},{"key":"2025122622550972000_2025.12.22.25342873v1.6","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2101746"},{"key":"2025122622550972000_2025.12.22.25342873v1.7","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.15-0477"},{"issue":"10","key":"2025122622550972000_2025.12.22.25342873v1.8","doi-asserted-by":"crossref","first-page":"1911","DOI":"10.1038\/s41564-023-01461-4","article-title":"Plasmodium falciparum resistant to artemisinin and diagnostics have emerged in Ethiopia","volume":"8","year":"2023","journal-title":"Nature Microbiology"},{"key":"2025122622550972000_2025.12.22.25342873v1.9","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0808859"},{"key":"2025122622550972000_2025.12.22.25342873v1.10","doi-asserted-by":"publisher","DOI":"10.1038\/s41579-024-01008-2"},{"key":"2025122622550972000_2025.12.22.25342873v1.11","doi-asserted-by":"publisher","DOI":"10.1038\/nature12876"},{"key":"2025122622550972000_2025.12.22.25342873v1.12","doi-asserted-by":"publisher","DOI":"10.1126\/science.1260867"},{"issue":"1","key":"2025122622550972000_2025.12.22.25342873v1.13","doi-asserted-by":"crossref","first-page":"e0132021","DOI":"10.1128\/AAC.01320-21","article-title":"Mutation in the Plasmodium falciparum BTB\/POZ Domain of K13 Protein Confers Artemisinin Resistance","volume":"66","year":"2022","journal-title":"Antimicrobial Agents and Chemotherapy"},{"key":"2025122622550972000_2025.12.22.25342873v1.14","unstructured":"World Health Organization. Malaria: Artemisinin partial resistance, January 2025."},{"key":"2025122622550972000_2025.12.22.25342873v1.15","doi-asserted-by":"publisher","DOI":"10.1038\/d41591-024-00028-y"},{"key":"2025122622550972000_2025.12.22.25342873v1.16","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc0805011"},{"key":"2025122622550972000_2025.12.22.25342873v1.17","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1314981"},{"key":"2025122622550972000_2025.12.22.25342873v1.18","doi-asserted-by":"publisher","DOI":"10.3201\/eid1405.071601"},{"issue":"1","key":"2025122622550972000_2025.12.22.25342873v1.19","first-page":"3314","volume-title":"Nature Communications","volume":"9","year":"2018"},{"key":"2025122622550972000_2025.12.22.25342873v1.20","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00686-12"},{"key":"2025122622550972000_2025.12.22.25342873v1.21","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(16)30415-7)"},{"key":"2025122622550972000_2025.12.22.25342873v1.22","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc1403007"},{"key":"2025122622550972000_2025.12.22.25342873v1.23","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(15)00487-9"},{"key":"2025122622550972000_2025.12.22.25342873v1.24","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(19)30391-3"},{"key":"2025122622550972000_2025.12.22.25342873v1.25","doi-asserted-by":"crossref","unstructured":"Mallika Imwong , Kanokon Suwannasin , Suttipat Srisutham , Ranitha Vongpromek , Cholrawee Promnarate , Aungkana Saejeng , Aung Pyae Phyo , Stephane Proux , Tiengkham Pongvongsa , Nguon Chea , Olivo Miotto , Rupam Tripura , Chau Nguyen Hoang , Lek Dysoley , Nghia Ho Dang Trung , Thomas J. Peto , James J. Callery , Rob W. van der Pluijm , Chanaki Amaratunga , Mavuto Mukaka , Lorenz von Seidlein , Mayfong Mayxay , Nguyen Thanh Thuy-Nhien , Paul N. Newton , Nicholas P. J. Day , Elizabeth A. Ashley , Francois H. Nosten , Frank M. Smithuis , Mehul Dhorda , Nicholas J. White , and Arjen M. Dondorp . Evolution of Multidrug Resistance in Plasmodium falciparum: a Longitudinal Study of Genetic Resistance Markers in the Greater Mekong Subregion. Antimicrobial Agents and Chemotherapy, 65(12):10.1128\/aac.01121\u201321, November 2021. Publisher: American Society for Microbiology.","DOI":"10.1128\/AAC.01121-21"},{"key":"2025122622550972000_2025.12.22.25342873v1.26","unstructured":"Global technical strategy for malaria, 2016-2030. Global Malaria Programme, World Health Organization, Geneva, Switzerland, 2015. OCLC: 949752352."},{"key":"2025122622550972000_2025.12.22.25342873v1.27","unstructured":"Global Technical Strategy for Malaria 2016-2030, 2021 Update. World Health Organization, Geneva, 1st ed edition, 2021."},{"issue":"5","key":"2025122622550972000_2025.12.22.25342873v1.28","doi-asserted-by":"crossref","first-page":"101027","DOI":"10.1016\/j.lanmic.2024.101027","article-title":"Selection of Plasmodium falciparum kelch13 mutations in Uganda in comparison with southeast Asia: a modelling study","volume":"6","year":"2025","journal-title":"The Lancet. Microbe"},{"issue":"1","key":"2025122622550972000_2025.12.22.25342873v1.29","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1186\/s12936-024-04848-8","article-title":"Emergence of Plasmodium falciparum strains with artemisinin partial resistance in East Africa and the Horn of Africa: is there a need to panic?","volume":"23","year":"2024","journal-title":"Malaria Journal"},{"key":"2025122622550972000_2025.12.22.25342873v1.30","doi-asserted-by":"crossref","unstructured":"Deus S. Ishengoma , Celine I. Mandara , Catherine Bakari , Abebe A. Fola , Rashid A. Madebe , Misago D. Seth , Filbert Francis , Creyton Buguzi , Ramadhan Moshi , Issa Garimo , Samwel Lazaro , Abdallah Lusasi , Sijenunu Aaron , Frank Chacky , Ally Mohamed , Ritha J. A. Njau , Jovin Kitau , Charlotte Rasmussen , Jeffrey A. Bailey , Jonathan J. Juliano , and Marian Warsame . Evidence of artemisinin partial resistance in North-western Tanzania: clinical and drug resistance markers study. medRxiv: The Preprint Server for Health Sciences, page 2024.01.31.24301954, February 2024.","DOI":"10.2139\/ssrn.4726181"},{"key":"2025122622550972000_2025.12.22.25342873v1.31","doi-asserted-by":"crossref","first-page":"484","DOI":"10.1186\/s12936-021-04021-5","article-title":"Efficacy and safety of artemether-lumefantrine and dihydroartemisinin-piperaquine for the treatment of uncomplicated Plasmodium falciparum malaria and prevalence of molecular markers associated with artemisinin and partner drug resistance in Uganda","volume":"20","year":"2021","journal-title":"Malaria Journal"},{"key":"2025122622550972000_2025.12.22.25342873v1.32","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.21-0214"},{"key":"2025122622550972000_2025.12.22.25342873v1.33","doi-asserted-by":"crossref","unstructured":"Pedro Rafael Dimbu , Roberta Horth , Ana Lu\u00edsa M. C\u00e2ndido , Carolina Miguel Ferreira , Felismina Caquece , Luzala Elisabeth Armando Garcia , Kialanda Andr\u00e9 , Garcia Pembele , Domingos Jandondo , Belmira Jos\u00e9 Bondo Benjamin Nieto Andrade , Sarah Labuda , Gabriel Ponce de Le\u00f3n , Julia Kelley , Dhruviben Patel , Samaly S. Svigel , Eldin Talundzic , Naomi Lucchi , Joana F. M. Morais , Filomeno Fortes , Jos\u00e9 Franco Martins , and Mateusz M. Pluci\u0144ski . Continued Low Efficacy of Artemether-Lumefantrine in Angola in 2019. Antimicrobial Agents and Chemotherapy, 65(2):10.1128\/aac.01949\u201320, January 2021. Publisher: American Society for Microbiology.","DOI":"10.1128\/AAC.01949-20"},{"issue":"1","key":"2025122622550972000_2025.12.22.25342873v1.34","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1186\/s12936-021-03585-6","article-title":"Anti-malarial efficacy and resistance monitoring of artemether-lumefantrine and dihydroartemisinin-piperaquine shows inadequate efficacy in children in Burkina Faso, 2017\u20132018","volume":"20","year":"2021","journal-title":"Malaria Journal"},{"issue":"9","key":"2025122622550972000_2025.12.22.25342873v1.35","doi-asserted-by":"crossref","first-page":"e540","DOI":"10.1016\/S1473-3099(24)00427-4","article-title":"Alarming Plasmodium falciparum resistance to artemisinin-based combination therapy in Africa: the critical role of the partner drug","volume":"24","year":"2024","journal-title":"The Lancet. Infectious Diseases"},{"key":"2025122622550972000_2025.12.22.25342873v1.36","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(15)70049-6"},{"key":"2025122622550972000_2025.12.22.25342873v1.37","first-page":"e105544","volume-title":"eLife","volume":"14","year":"2025"},{"key":"2025122622550972000_2025.12.22.25342873v1.38","doi-asserted-by":"crossref","unstructured":"Malaria GEN , MH Abdelraheem , MM Abdel Hamid , DO Acheampong , I Adam , P Aide , O Ajibaye , M Ali , J Almagro-Garcia , A Amambua-Ngwa , L Amenga-Etego , I Aniebo , E Aninagyei , F Ansah , TO Apinjoh , CV Ariani , S Auburn , GA Awandare , A Balmer , P Bejon , S Boene , G Bwire , B Candrinho , A Chidimatembue , K Chindavongsa , K Comiche , D Conway , A Dara , M Diakite , A Djimde , A Dondorp , S Doumbia , E Drury , CA Fanello , M Ferdig , K Figueroa , D Gamboa , L Golassa , S Goncalves , MdA Guindo , M Hamaluba , B Hanboonkunupakarn , K Howe , M Hussien , M Imwong , D Ishengoma , J Jeans , A Kabaghe , A Kamuhabwa , JM Kindermans , DS Konate , DP Kwiatkowski , C Lee , SK Lee , SJ Lee , B Ley , A Llanos-Cuentas , J Marfurt , G Matambisso , RR Maude , RJ Maude , A Mayor , M Mayxay , O Maiga-Ascofare , RS McCann , A Miles , O Miotto , AO Mohamed, C. Morang\u2019a, K Murie , BE Ngasala , TN Nguyen , O Nolasco , F Nosten , R Noviyanti , Isla O\u2019Connor, M Oboh , LI Ochola-Oyier , C Olufunke Falade , A Olukosi , A Olumide , FI Olusola , MA Onyamboko , EC Oriero , WA Oyibo , D Pannebaker , RD Pearson , K Phiri , RW van der Pluijm , RN Price , HH Quang , V Rajkumar , M Randrianarivelojosia Devaraju , L Ranford-Cartwright , JC Rayner , E Rovira-Vallbona , K Rowlands , V Ruano-Rubio , JF Sanchez , F Saute , S Shettima , C da Silva , VJ Simpson , S Suddaby , W Takken , AM Thu , M Toure , E Unlu , HO Valdivia , M van Vugt , N Waithira , T Wellems , J Wendler , N White , and R Wuendrich Ogidan . Pf8: an open dataset of Plasmodium falciparum genome variation in 33,325 worldwide samples [version 1; peer review: 2 approved]. Wellcome Open Research, 10(325), 2025.","DOI":"10.12688\/wellcomeopenres.24031.1"},{"issue":"5","key":"2025122622550972000_2025.12.22.25342873v1.39","first-page":"129","volume-title":"Tropical Medicine and Infectious Disease","volume":"10","year":"2025"},{"key":"2025122622550972000_2025.12.22.25342873v1.40","doi-asserted-by":"crossref","unstructured":"Jonathan J. Juliano , Cecile P. G. Meier-Scherling , Neeva Wernsman Young , George A. Tollefson , Sean V. Connelly , Jonathan B. Parr , Melissa D. Conrad , Jacob M. Sadler , Christopher M. Hennelly , Ashenafi Assefa , Lucy Okell , Abebe A. Fola , Karamoko Niar\u00e9 , Jacob Marglous , Kelly Carey-Ewend , Ronald Futila Kyong-Shin , Isabela Gerdes Gyuricza , Gina Cuomo-Dannenburg , Shazia Ruybal-Pes\u00e1ntez , Oliver J. Watson , Robert Verity , and Jeffrey A. Bailey . Toward Setting Minimum and Optimal Data to Report for Malaria Molecular Surveillance with Targeted Sequencing: The \u201cWhat\u201d and \u201cWhy\u201d. September 2025. Section: The American Journal of Tropical Medicine and Hygiene.","DOI":"10.20944\/preprints202503.0561.v2"},{"key":"2025122622550972000_2025.12.22.25342873v1.41","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.19-0706"},{"key":"2025122622550972000_2025.12.22.25342873v1.42","unstructured":"World Health Organization. WHO malaria threats map: tracking biological challenges to malaria control and elimination., 2017."},{"key":"2025122622550972000_2025.12.22.25342873v1.43","doi-asserted-by":"crossref","first-page":"22","DOI":"10.12688\/wellcomeopenres.18681.1","article-title":"Pf7: an open dataset of Plasmodium falciparum genome variation in 20,000 worldwide samples","volume":"8","year":"2023","journal-title":"Wellcome Open Research"},{"key":"2025122622550972000_2025.12.22.25342873v1.44","unstructured":"Matthew J. Page , Joanne E. McKenzie , Patrick M. Bossuyt , Isabelle Boutron , Tammy C. Hoffmann , Cynthia D. Mulrow , Larissa Shamseer , Jennifer M. Tetzlaff , Elie A. Akl , Sue E. Brennan , Roger Chou , Julie Glanville , Jeremy M. Grimshaw , Asbj\u00f8rn Hr\u00f3bjartsson , Manoj M. Lalu , Tianjing Li , Elizabeth W. Loder , Evan Mayo-Wilson , Steve McDonald , Luke A. McGuinness , Lesley A. Stewart , James Thomas , Andrea C. Tricco , Vivian A. Welch , Penny Whiting , and David Moher . The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ (Clinical research ed.), 372:n71, March 2021."},{"key":"2025122622550972000_2025.12.22.25342873v1.45","unstructured":"Jonathan B. Parr , Jeffrey A Bailey , Kelly Carey-Ewend , Sean V. Connelly , Melissa D Conrad , Gina Cuomo-Dannenburg , Abebe A. Fola , Isabela Gerdes Gyuricza , Jonathan J. Juliano , Ronald Futila Kyong-Shin , Jacob Marglous , Cecile Meier-Sherling , Karamoko Niar\u00e9 , Lucy Okell , Shazia Ruybal-Pes\u00e1ntez , Alfred Simkin , George A. Tollefson , Robert Verity , Oliver Watson , Neeva Wernsman Young , and Zachary Popkin-Hall . Mapping the prevalence of molecular markers of artemisinin partial and partner drug antimalarial resistance in Africa: a spatial and temporal modelling study."},{"key":"2025122622550972000_2025.12.22.25342873v1.46","unstructured":"Covidence systematic review software, Veritas Health Innovation, Melbourne, Australia. Available at https:\/\/www.covidence.org."},{"issue":"4","key":"2025122622550972000_2025.12.22.25342873v1.47","first-page":"410","volume-title":"The American Journal of Tropical Medicine and Hygiene","volume":"72","year":"2005"},{"issue":"1","key":"2025122622550972000_2025.12.22.25342873v1.48","first-page":"162","volume-title":"The American journal of tropical medicine and hygiene","volume":"75","year":"2006"},{"issue":"1","key":"2025122622550972000_2025.12.22.25342873v1.49","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1186\/s12936-017-1791-2","article-title":"Characterization of Plasmodium falciparum genes associated with drug resistance in Hodh Elgharbi, a malaria hotspot near Malian\u2013Mauritanian border","volume":"16","year":"2017","journal-title":"Malaria Journal"},{"issue":"4","key":"2025122622550972000_2025.12.22.25342873v1.50","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1016\/j.meegid.2005.09.001","article-title":"Amodiaquine resistant Plasmodium falciparum malaria in vivo is associated with selection of pfcrt 76T and pfmdr1 86Y","volume":"6","year":"2006","journal-title":"Infection, Genetics and Evolution"},{"key":"2025122622550972000_2025.12.22.25342873v1.51","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00968-08"},{"key":"2025122622550972000_2025.12.22.25342873v1.52","doi-asserted-by":"publisher","DOI":"10.1086\/427997"},{"issue":"4","key":"2025122622550972000_2025.12.22.25342873v1.53","doi-asserted-by":"crossref","first-page":"704","DOI":"10.1093\/cid\/ciac527","article-title":"Malaria Transmission Dynamics in a High-Transmission Setting of Western Kenya and the Inadequate Treatment Response to Artemether-Lumefantrine in an Asymptomatic Population","volume":"76","year":"2023","journal-title":"Clinical Infectious Diseases"},{"key":"2025122622550972000_2025.12.22.25342873v1.54","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1016\/j.ijid.2021.07.008","article-title":"Artemether-lumefantrine treatment failure of uncomplicated Plasmodium falciparum malaria in travellers coming from Angola and Mozambique","volume":"110","year":"2021","journal-title":"International Journal of Infectious Diseases"},{"key":"2025122622550972000_2025.12.22.25342873v1.55","doi-asserted-by":"crossref","unstructured":"Khalid B. Beshir , Nouhoum Diallo , Fabrice A. Som\u00e9 , Salif Sombie , Issaka Zongo , Bakary Fofana , Aliou Traore , Souleymane Dama , Amadou Bamadio , Oumar B. Traore , Sam A. Coulibaly , Ouattara S. Maurice , Amidou Diarra , Jean Moise Kabor\u00e9, Aly Kodio , Amadou Hamidou Togo , Niawanlou Dara , Moctar Coulibaly , Francois Dao , Frederic Nikiema , Yves D. Compaore , Naomie T. Kabore , Nouhoun Barry , Issiaka Soulama , Issaka Sagara , Sodiomon B. Sirima , Jean-Bosco Ou\u00e9draogo , Abdoulaye Djimde , and Colin J. Sutherland . Persistent Submicroscopic Plasmodium falciparum Parasitemia 72 Hours after Treatment with Artemether-Lumefantrine Predicts 42-Day Treatment Failure in Mali and Burkina Faso. Antimicrobial Agents and Chemotherapy, 65(8):10.1128\/aac.00873\u2013 21, July 2021. Publisher: American Society for Microbiology.","DOI":"10.1128\/AAC.00873-21"},{"key":"2025122622550972000_2025.12.22.25342873v1.56","doi-asserted-by":"crossref","unstructured":"Colin J. Sutherland , Paul Lansdell , Mandy Sanders , Julian Muwanguzi , Donelly A. van Schalkwyk , Harparkash Kaur , Debbie Nolder , Julie Tucker , Hayley M. Bennett , Thomas D. Otto , Matthew Berriman , Trupti A. Patel , Roderick Lynn , Effrossyni Gkrania-Klotsas , and Peter L. Chiodini . pfk13-Independent Treatment Failure in Four Imported Cases of Plasmodium falciparum Malaria Treated with Artemether-Lumefantrine in the United Kingdom. Antimicrobial Agents and Chemotherapy, 61(3):10.1128\/aac.02382\u201316, February 2017. Publisher: American Society for Microbiology.","DOI":"10.1128\/AAC.02382-16"}],"container-title":[],"original-title":[],"link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.64898\/2025.12.22.25342873","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,27]],"date-time":"2025-12-27T06:55:22Z","timestamp":1766818522000},"score":1,"resource":{"primary":{"URL":"http:\/\/medrxiv.org\/lookup\/doi\/10.64898\/2025.12.22.25342873"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,23]]},"references-count":56,"URL":"https:\/\/doi.org\/10.64898\/2025.12.22.25342873","relation":{},"subject":[],"published":{"date-parts":[[2025,12,23]]},"subtype":"preprint"}}